testing for herpes

a few nights ago I slept with someone for the first time in months and we used condoms through out the whole time. After we had sex he tells me 'Btw, I have herpes' I felt so betrayed that I can't even put it into words. I asked him why didn't tell me earlier and his response was 'I forgot' As much as I liked this person i just felt like i had the rug pulled out from under me. He should of told me before so that i could of done my own research and come to my own conclusions on what my comfort level would be. All day i've been reading different websites on herpes information and i was wondering if anyone knows what the window period is for testing for herpes and what types of tests are available. The person I was with has had herpes for four years and hasn't had an outbreak in over a year. I asked him where he gets the outbreak and he said in the pubic hair region so the condom doesn't even cover that. Yay me!

I spoke two different counslers, one from the cdc and one from national herpes hotline and got very, very different information. From the CDC i was told that there really isn't a test available for herpes and a person needs to have an outbreak in order to be diagnosed which can be anywhere from 2 days to years. If this is true, what do I tell people? I'm 23 years old, single, and if i have sex with someone do I just say 'I might have herpes but i'm not really sure'
The woman from the herpes hotline told me that there are tests available, some more reliable than others. She told me about the Captia test and that it is very reliable however it's not available in many places. I called my health dept. and asked them if they offer this test and was told that they don't but they do offer a different type of blood test however it's not that reliable and they don't even recommend it. According to them every other person may test positive on it due to cold sores or if they ever had chicken pox.
If you guys have any info, i'd greatly appreciate it!

First of all - sorry you were treated badly by this guy. Of course, he should have told you before you had sex, and it's pretty awful that he didn't.

OK, regarding testing: you know, when I was first concerned about having herpes, I called several helplines here in the UK where I live about how I could be tested. I found that my reading of a medical encyclopedia and a couple of webpages meant that I knew more than most of the people I was speaking to on the supposed "helplines". What's also concerning is that I know more about herpes than a couple of my friends who are doctors!

There are two ways of testing for herpes:

1. A type-specific blood test. Your health department may be referring to a non-type specific blood test, which may not distinguish between types 1 and 2. The significance is that anything between 40 to 80% of people will test positive for type 1, the virus which causes the vast majority of cold sores on the mouth (type 2 causes a minority of the problems there). Many people acquire this virus as a child, have one cold sore, and never see any other problems. They will still most likely test positive for herpes on a test though.

Type 2 is the classic genital herpes (although you can also get it on the mouth in rare cases, and type 1 is also increasingly found genitally) and the infection rates for this are lower.

The thing about a blood test is that it won't tell you WHERE you have the virus. If you test positive for type 2, it is reasonable to assume the infection is genital as oral infections of type 2 are quite rare. If you test positive for type 1, the balance is in favour of an oral infection, although as I have said, type 1 is on the increase genitally (I have it both genitally and orally).

You will need to wait around 12-16 weeks to be confident that a blood test has been accurate. I think in the USA you are probably looking for something called the Western Blot (they have different names here) as this distinguishes between the different types - perhaps a USA resident can confirm this?

2. The other way of testing is a culture of the sore, taken by it being swabbed. This can be more helpful as it tells you what virus you have, and where i.e. if a genital sore tests positive for type 1, then you know that you have type 1 genitally - whereas a blood test only tells you that you have the virus and not where you need to be concerned about it.

The downside is that cultures need to be carried out very soon after any sore appears - within 1 to 2 days, otherwise there is a significant risk of a false negative. Also, not all herpes symptoms are suitable for a culture test. A lot of people get herpes outbreaks which manifest as a scratch or a cut in the skin. These usually do not yield very good culture tests - they work better on the classic blisters and sores.

It's a good thing that you have used condoms but as you have realised, herpes outbreaks can occur anywhere in the genital region (and beyond e.g. the inside of thighs, top of the legs etc) and condoms are not as effective at preventing transmission of this skin to skin virus as they are at stopping viruses passed by bodily fluids.

Thank you so much for responding. I had no idea that I needed to wait that long for a test and already made an appoitment with a doctor for next thursday which will be about a week since the encounter.

Well, most people will get the antibodies (it's the antibodies they test for you in your blood) within a couple of weeks, but with some people it takes significantly longer. You could get tested now but you should probably retest after 3 or 4 months to be certain about the results. Good luck.

just to touch on a point made by beaker, the western blot isn't a "standard" test, per se. It is supposed to be the the most accurate blood test for herpes, but it's not going to be the one your doctor will order for you if you just come in and ask to have a herpes test. If you are interested in it, you'll have to make the arrangements through the University of washington (the only place that does the Western Blot), and arrange it with your doctor as well. Also, I've been told that most insurance companies won't cover this test. Considering your exposure was so recent, the best thing would be trying to get a swab/culture. however, if you don't have lesions that this can be done with, try what was suggested and you can get a type-specific blood test now and then again after 3-4 months.

I had had countless amounts of sex with my partner over a number of years and i never caught anything, we didn't take any precautions as i didn't believe he had anything and he had 'forgotten' he had type two. He did tell me once he got a tiny ob which you could hardly even see and it had dried up in a week and you couldn't see anything, but still we took the precaution of using a condom as we both 'thought' that was what you did, use condoms. How wrong we were!! That was when i caught the virus and two months down the track i got my first ob.

I still believe that if we had abstained a bit longer i wouldn't have got it, but then again, if you are in a committed relationship, you figure you will likely catch it some day. At the time i did wonder, 'how do you forget you have this', but he has had this for 20 years and has only had about 4 ob's and prior to this last ob, the last one before that was about 10 years ago. My last ob was a few months ago now and during the course of my day i don't really give it much thought and often a number of days will go by that i've not thought of it. Mostly i am reminded by it when i take my vitamins and of course when i read these boards. Still, when it comes to sex and somebody asking you if you are std free, it's not something which i think should so easily slip the mind.

If he wasn't on the verge of having an ob or in the middle or finish of one, i'd say you have a pretty good chance of getting away with it. Fingers crossed you don't have it and i hope you have learnt some valuable lessons off the boards and lessons you could pass onto friends so they don't end up in the same boat.

One other thing, if you ever decide to get intimate with someone, just asking them if they've had an std test isn't enough. You have to specifically ask a future partner about herpes. The typical std test doesn't automatically test a person for herpes, you have to ask for it as it's a seperate test, so if a future partner as only had an std test, this isn't good enough.

I'm still extrememly p.o'd at what happened. Funny part is a couple of days before the intercourse we had a conversation over the phone on std's and he told me that he gets tested on a regular basis and that he doesn't have anything. When I reminded him about it after he told me he has herpes his response was that he meant to tell me before we had sex but he didn't want to tell me over the phone. He said that in the heat of the moment he just 'forgot'

I understand that herpes is not life threatening and millions of people have it but what gets me is the betrayel. To him it's not a big deal, he said that his doctor told him that 1 out 5 ppl has herpes and not to even give it a second thought. I don't know if this makes any sense or not but his doctor never took a culture of the sore to send in into a lab. He just had a visual exam and was diagnosed that way. After reading the web I was under the impression that if there's a current outbreak a doctor should take a culture. Also, he mentioned that the doctor took a blood test for herpes and that the test came back negative but his doctor told him that the test is not too reliable and since he had a current outbreak at the time that it is in fact herpes.

After reading this board and getting so much helpful advice I understand this virus a little better. I asked him which type of herpes he has and he said that he didn't know. He didn't even know that there were two types of herpes. After I explained everything that i knew about this he made an appoitment with a clinic to get examined once again.

It's been 4 days since the exposure and nothing yet...being very, very hopefull!

To him it's not a big deal, he said that his doctor told him that 1 out 5 ppl has herpes and not to even give it a second thought. I don't know if this makes any sense or not but his doctor never took a culture of the sore to send in into a lab. He just had a visual exam and was diagnosed that way. After reading the web I was under the impression that if there's a current outbreak a doctor should take a culture. Also, he mentioned that the doctor took a blood test for herpes and that the test came back negative but his doctor told him that the test is not too reliable and since he had a current outbreak at the time that it is in fact herpes.

*shaking head at doctors* Honestly.

You CANNOT diagnose herpes just by looking. You really can't. Some people have the absolutely classic blisters, and you might think that looking at something like that that someone HAS to have herpes, but it's not necessarily the case. A lot of herpes symptoms in fact can be mistaken for other things - and vice versa. The ONLY ways to tell if someone has herpes are to culture the sore (which should be done within 48 hours of it appearing) or to get a blood test (which should be done 4 months after exposure to be as reliable as possible). It's a good sign if this guy tested negative for herpes, but as I say it needs to be done 4 months after the possible infection which people are concerned about, to be certain. All this diagnosing by sight thing is nonsense, and it's causing a great deal of worry where there might not need to be any as the person may not even have herpes.

The figures for herpes type 2 (which causes the majority of genital herpes, although type 1 is increasingly genitally) used to be around 17-25% in the US (although genital herpes rates are by no means negligible in most parts of the world, for some reason they were always higher in the US than in e.g. Europe) but have recently been dropping to significantly lower than this. So it used to be true to say that 1 in 4 or 1 in 5 people had genital herpes, but that may not hold true for very much longer. It's probably lower than that, although still significant (i.e. more than 1 in 10).

The figure for type 1 (which causes the majority of oral herpes cases) used to be as high as 80% but is probably around 50% now (40% in some studies).

spjp, if you come back positive for type 1, that wont necessarily determine "where" the type 1 is located on your body. Meaning it could be type 1 from your classic cold sores which so many people get at their mouth or it could be type 1 genitally which you caught sexually/orally from a partner.

Depending which blood test they give you, it's preferable to get one which singles out the 'type' of herpes you have. No blood test will give a 'location'.

Having said this, first time round i had the Western Blot test and i came back negative for both type 1 & 2, yet i do get and have had cold sores at my mouth off and on since i was a kid. I was surprised to test negative for that.

went to the doctor and he said i shouldn't have anything to worry about but i wanted to take the blood test anyway, so i did.

if i come back hsv 1 - does it really mean anything, because ive had a cold sore before and from what ive read 5-80% of people will test positive to it?

and if i do have hsv-1 in my body, should i still receieve oral sex - knowing the fact that it could be on my genitals?

It would be quite unlikely for you to test negative for herpes type 1, because you have had a cold sore, however as Audrey's experience shows, false negatives do happen. If it was a cold sore that you had, you already have type 1 (there is a very small chance it was type 2, but this is not very likely).

It's true that a blood test won't tell you whether you also have type 1 of the genitals.

Bearing in mind how many people have herpes type 1, there is no advice given to those with herpes type 1 that they should generally refrain from giving or receiving oral sex. You should not carry out these activities during outbreaks and you could consider using protection.